Provider Demographics
NPI:1447526231
Name:MUTHULINGAM, DHARUSHANA (MD)
Entity type:Individual
Prefix:DR
First Name:DHARUSHANA
Middle Name:
Last Name:MUTHULINGAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 504934
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-4934
Mailing Address - Country:US
Mailing Address - Phone:314-821-0900
Mailing Address - Fax:800-556-8932
Practice Address - Street 1:1004 KENNERLY RD
Practice Address - Street 2:STE 171 B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-821-0900
Practice Address - Fax:800-556-8932
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2019020528207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine